Resection and Reconstruction of Cribriform Adenocarcinoma of the Posterior One-third of the Tongue - A Case Report.

RATIONALE: Cribriform adenocarcinoma of the tongue and minor salivary glands (CATMSG) is a very rare salivary gland tumour mimicking adenoid cystic carcinoma (AdCC) or polymorphous low-grade adenocarcinoma, impacting treatment, prognosis and management.

PATIENT CONCERNS: A 71-year-old female presented with a painful, bleeding left tongue mass. An external biopsy reported AdCC.

DIAGNOSIS: A rebiopsy at our centre diagnosed the lesion as a classic CATMSG: cribriform architecture, pale overlapping nuclei and S-100/SMA positivity on immunohistochemistry.

TREATMENT AND OUTCOMES: Based on the revised diagnosis, the patient underwent composite resection, neck dissection and free flap reconstruction. Final pathology confirmed CATMSG (pT3 pN0) with perineural invasion. She recovered well and was referred for adjuvant radiotherapy.

TAKE-AWAY LESSONS: This case highlights that an accurate distinction of CATMSG from AdCC is essential, as it mandates specific surgical and adjuvant strategies. Expert histopathological review is critical for optimal, tailored patient care.